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Posted 6/2/2017 5:31 PM (GMT 0)
I am 57 years old, yesterday I was diagnosed with prostate cancer, with a Gleason score of 6(3+3). My prostate volume is 100.5cc and prostate size is 6.4x5.3x5.7cm. The MRI showed a T2 dark lesion, which is where the cancer was found. My urologist recommends Active Surveillance at this time, with PSA tests every three months and a minimum of one biopsy a year. My last PSA numbers were 10.5. My PSA numbers have been as high as 12.5 and tend to go up and down slightly each time tested. I have been on this forum for about a month and have read a lot of posts and responses by very knowledgeable members. I'm hoping to get some comments by members regarding my diagnosis and treatment. Currently I will follow my doctors recommendation of AS, until September when I have another PSA test. I am currently taking Avodart and will be starting Flomax next week, once I stop the Avodart.
Posted 6/2/2017 7:30 PM (GMT 0)
AS is a good way to go. You should get a second opinion on the biopsy slides.

Seems to me that a lot of your PSA could be explained by prostate size. I think you'll do well on AS for a very long time. Just remember that it's "Active surveillance," and you need to keep up a regular testing schedule.

Hang in there,
Andrew
Posted 6/2/2017 7:42 PM (GMT 0)
Paul, welcome to the forum, sorry about your diagnosis, but as prostate cancer goes, it's seems on the surface to be the fairly indolent kind, so AS sounds like it might make sense for you if you are comfortable with it.

How many cores were taken and how many were positive. It sounds like just one positive core, if that's the case AS is almost a no brainer. Is it?

Your PSA sounds high for one core G6, but as Andrew said, it could be partly the size of your prostate.

Good luck, and stick around, keep us posted.
Posted 6/2/2017 8:05 PM (GMT 0)
You obviously have something else going on other than a small amount of prostate cancer (for which AS is ideal). How long have you been taking Avodart, how did it affect your PSA, and why are you discontinuing it? (You understand your PSA will jump up when you discontinue it, right?) You must have BPH if you are taking Avodart - how big is your prostate? The see-saw pattern you noticed is characteristic of relapsing and remitting prostatitis. You may have some urinary retention too that is causing your PSA to be that elevated.

Consider monitoring with PHI instead of PSA - it is less affected by whatever else you have going on.

Also a good idea to have Epstein double check your Gleason scores.
Posted 6/3/2017 12:55 PM (GMT 0)
There were 14 cores taken and one was positive. This was my fourth biopsy. The doctor prescribed Avodart the past two biopsies to slow down the bleeding during urination, as I had a lot of clots. The Avodart, for me, left me with virtually no bleeding or clots, when urinating after the biopsies. I have restarted my daily aspirin and will stop the Avodart soon.
I thank you all for any and all of your expertise.
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